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PATTERN OF ANTI EPILEPTIC DRUG ADVERSE EFFECT IN TERTIARY REFERRAL HOSPITAL Damayanti, Ria; Husna, Machlusil; Mondiani, Yeni Quinta; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

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Background: Epilepsy is a major chronic neurological problem in the world. The goal of epilepsy therapy is seizure-free and without side effects. The emergence of side effects in patients with epilepsy will be its limitations that can cause the failure of epilepsy therapy. Therefore, it is necessary to do a simple descriptive study, which illustrates the pattern of side effects of anti-epileptic drugs that occur in people with epilepsy, so that later clinicians are more alert and can take preventative measures.Objective: Knowing the pattern of side effects of antiepileptic drugs at the Neurology Outpatient Clinic dr. Saiful Anwar hospital.Methods: This research is an observational descriptive study. Samples were taken by filling the questionnaire at the Neurology Outpatient Clinic dr. Saiful Anwar hospital. Demographic data in this study will be presented in the frequency distribution table. Chi Square test is used to determine the relationship of demographic data, also the pattern of therapy with the side effects that arise.Results: 93 epilepsy patients were involved in the study. More than 40% of patients experience side effects. The most common side effects appear in idiopathic epilepsy (30.1%). Based on the duration of epilepsy, the most side effects appear in epilepsy duration> 10 years (17.2%). However, from the results of the influence test using chi square, there was no significant difference between the duration of epilepsy with the appearance of side effects, even the type of epilepsy (p-value> 0.05). 28 patients who experience side effects, appear after the duration of use of AED 1 - 5 years. It was found that the duration of AED uses affected the emergence of side effects (p-value <0.05).Conclusion: Side effects occur in patients taking anti-epileptic drugs, and are related to the duration of drug use. This data can be used to increase the awareness of clinicians related to the emergence of side effects in patients who consume AED.

Possible Role of Akt in Mossy Fiber Sprouting: Akt Activity and CA3 Mossy Fiber Sprouting in a Kainate Model of Epilepsy: Akt Activity and CA3 Mossy Fiber Sprouting in Epilepsy husna, Machlusil; Handono, Kusworini; Sujuti, Hidayat; Aulanni'am, Aulanni'am
Journal of Tropical Life Science Vol. 14 No. 3 (2024): In Press
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.14.03.09

The most prevalent pathological phenomenon observed in patients with epilepsy is hippocampal mossy fiber sprouting (MFS), which is thought to be associated with epileptic progression, such as worsening seizure control, cognitive function, and behavior. MFS is discovered in the dentate gyrus and the hippocampal Cornu Ammon 3 (CA3) area. The CA3 area is involved in memory, so disturbances in that area can affect memory impairment in patients with epilepsy. The mammalian target of rapamycin complex-1 (mTORC1) is also associated with MFS. Akt is an upstream activator of mTORC1 and a downstream target of mammalian target of rapamycin complex-2 (mTORC2) and plays a role in cytoskeleton organization. We analyzed Akt activity and MFS in the CA3 zone in an in vitro model of kainate-induced epilepsy. We divided organotypic hippocampal slice cultures (OHSCs) into a kainate (epilepsy) group and a control (untreated) group. On the 10th day in vitro (DIV), the kainate group was exposed to 8 µM kainic acid for 48 h, diluted in the medium. At 32 DIV, we measured Akt activity through western blotting and CA3 MFS through synaptoporin fluorescence intensity observed using confocal laser scanning microscopy. We found that Akt activity increased significantly (p = 0.000) in the kainate group, and the synaptoporin fluorescence intensity also increased in the stratum oriens of the CA3 area (p = 0.049) in the kainate group. Our findings implied that Akt may play a role in MFS development. Because Akt is a main downstream target of mTORC2, mTORC2 may also be involved in MFS development. Further research is required to clarify these findings.

ANALISIS DEMOGRAFI EPILEPSI PEDIATRIK DI RUMAH SAKIT SAIFUL ANWAR MALANG INDONESIA Husna, Machlusil; Rahma, Annisa
Majalah Kesehatan Vol. 11 No. 4 (2024): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2024.011.04.6

Epilepsi pada anak merupakan sebuah tantangan diagnosis dan pemahaman yang komprehensif mengenai etiologi, frekuensi kejang, hasil EEG, dan penggunaan obat anti epilepsi penting untuk tatalaksana tepat. Data pola epilepsi pediatrik yang komprehensif pada RSUD Dr. Saiful Anwar Malang saat ini belum diketahui sehingga dilaksanakan penelitian ini untuk mengisi kekosongan pengetahuan tersebut. Penelitian ini bertujuan untuk menyelidiki profil pasien epilepsi pediatrik di Rumah Sakit Umum Daerah Saiful Anwar, Malang. Penelitian ini menggunakan rekam medis pasien yang mengunjungi rumah sakit antara Januari 2015 dan Desember 2019 lalu dianalisis. Penelitian ini melibatkan total 951 pasien pediatrik, sebagian besar laki-laki, dengan usia rata-rata 0-5 tahun. Mayoritas kasus menunjukkan etiologi idiopatik (80%), dengan 61,13% menunjukkan pembacaan EEG yang normal. Patut dicatat bahwa lebih dari 24% orang tua dari pasien pediatrik tidak mengetahui modalitas terapi yang digunakan dalam pengobatan mereka. Lesi lobus temporal diidentifikasi sebagai penyebab utama pada 14% pasien. Temuan kami menunjukkan bahwa karakteristik jenis kelamin, usia, dan lokasi kejang konsisten dengan yang dilaporkan dalam literatur yang ada. Namun, tingkat EEG abnormal yang lebih rendah dari yang diperkirakan dan distribusi etiologi spesifik memberikan wawasan baru yang dapat menginformasikan penelitian di masa depan dan praktik klinis dalam mengelola epilepsi pediatrik.

Possible Role of Akt in Mossy Fiber Sprouting: Akt Activity and CA3 Mossy Fiber Sprouting in a Kainate Model of Epilepsy: Akt Activity and CA3 Mossy Fiber Sprouting in Epilepsy husna, Machlusil; Handono, Kusworini; Sujuti, Hidayat; Aulanni'am, Aulanni'am
Journal of Tropical Life Science Vol. 14 No. 3 (2024)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.14.03.09

The most prevalent pathological phenomenon observed in patients with epilepsy is hippocampal mossy fiber sprouting (MFS), which is thought to be associated with epileptic progression, such as worsening seizure control, cognitive function, and behavior. MFS is discovered in the dentate gyrus and the hippocampal Cornu Ammon 3 (CA3) area. The CA3 area is involved in memory, so disturbances in that area can affect memory impairment in patients with epilepsy. The mammalian target of rapamycin complex-1 (mTORC1) is also associated with MFS. Akt is an upstream activator of mTORC1 and a downstream target of mammalian target of rapamycin complex-2 (mTORC2) and plays a role in cytoskeleton organization. We analyzed Akt activity and MFS in the CA3 zone in an in vitro model of kainate-induced epilepsy. We divided organotypic hippocampal slice cultures (OHSCs) into a kainate (epilepsy) group and a control (untreated) group. On the 10th day in vitro (DIV), the kainate group was exposed to 8 µM kainic acid for 48 h, diluted in the medium. At 32 DIV, we measured Akt activity through western blotting and CA3 MFS through synaptoporin fluorescence intensity observed using confocal laser scanning microscopy. We found that Akt activity increased significantly (p = 0.000) in the kainate group, and the synaptoporin fluorescence intensity also increased in the stratum oriens of the CA3 area (p = 0.049) in the kainate group. Our findings implied that Akt may play a role in MFS development. Because Akt is a main downstream target of mTORC2, mTORC2 may also be involved in MFS development. Further research is required to clarify these findings.

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